A pilot study of the effects of niacin administration on free fatty acid and growth hormone concentrations in children with obesity

摘要

Summary Context Children with obesity have low spontaneous growth hormone (GH) secretion. High circulating free fatty acid (FFA) concentration is believed to inhibit GH secretion in those with obesity. In adults, lipolytic inhibition with niacin lowers FFA and increases GH, but there are no prior studies in children with obesity. Objective The objective of the study was to determine the dose and frequency of niacin administration required to lower FFA and stimulate GH in children with obesity. Design Dose‐finding study of nondiabetic children ages 6–12?years with body mass index (BMI)?≥?95th percentile given niacin 250?mg q2h?×?3 doses ( n ?=?2), 500?mg q2h?×?3 doses ( n ?=?5) or 500?mg q1h?×?4 doses ( n ?=?5). Participants Eight boys and four girls (age 9.7?±?1.8?years; BMI 26.4?±?3.1?kg?m ?2 ; BMIz 2.2?±?.25) were studied. Main Outcome Percentage of serum FFA values that were below 0.2?mEq?L ?1 . GH, insulin and glucose were also measured serially. Results FFA decreased as the dose and frequency of niacin increased ( p ?=?.01). Niacin 500?mg q1h 4 doses suppressed FFA??0.2?mEq?L ?1 and significantly increased GH ( p ?=?.04). Adverse effects were flushing/warmth (100%), tingling (60%) and GI complaints (20–40%). Conclusions Niacin 500?mg q1h significantly lowered serum FFA and increased GH. These pilot data suggest that high FFA is an important suppressor of GH secretion in children with obesity.